Predictive Analytics

Q: How much of the healthcare industry has adopted predictive analytics?

A: By definition, negotiations between providers and payers are a game of who can better predict patient outcomes. Win-win scenarios can certainly be devised, but a lack of predictive ability puts an organization at risk for poor contract structuring.

Clinical outcomes are increasingly a game of predicting outcomes and identifying the levers that affect those outcomes so providers are able to improve on future outcomes. Operational predictions are also important, as misunderstanding patient care needs can lead to expensive outlier care patterns or care variations that break capacity management efforts and budgets.

Q: How do you see predictive analytics having an impact on healthcare organizations, and specifically on heart hospitals?

A: Outcome prediction and risk profiling will increasingly guide care pathway selection and tailor care patterns to targeted patient profiles. Predicting and applying the care pathway that leads to the best health outcome at the lowest cost is the foundation of healthcare in the value-based purchasing era.

The dynamics of heart health are increasingly being researched and documented, leading to continued technical evolution and improved outcomes. Being able to predict which technology will lead to the best patient outcomes per dollar spent--whether it be a TVR, and VAD, or an aspirin—is a crucial skill for providers.

Q: What is the role of predictive analytics in affecting areas like heart failure readmissions?

A: Estimates continue to suggest that as much as 20 percent or more of care is wasted. Access to predictive models for identifying patients at risk for readmissions--and providing better targeted treatment up front--are the keys to reducing readmission. Those who best understand their care pathways and patient risk profiles will be the ones who can provide the best value in heart failure care. They will be the ones who can best explain the risk factors inherent in their readmission outcomes to stakeholders from patients to community groups and regulators.

Exploring CV Service Line Analytics

Q: Where should heart hospitals begin if they want to start using data analytics?

A: Digitization is the key. Start by identifying areas where paper continues to hide data rather than illuminate care process dynamics. For all digital information, build standards for producing and consuming data so that the data collected has meaning, and those who need the information have access and know what to do with the information available.

Q: What unique challenges do heart hospitals face that can be addressed by healthcare analytics?

A: Understanding biometrics, imaging data, labs, medications, process, and outcomes measures make for a richly complex set of data to leverage to drive value in cardiovascular care.

Q: How can data analytics improve clinical care in a cardiology department?

A: With good data governance, a cardiology department can efficiently care for a variety of patients. With well-controlled processes to ensure proper procedures and medication therapies applied, patient health risks and quality of life are managed effectively.

Q: Who are the end users of an analytics product at a heart hospital? Who else should see that data and analysis?

A: The care teams are the key consumers of analytics products at a heart hospital. Clinical and administrative leaders need to know:

Whether health care processes are working

How well they are doing at achieving positive health outcomes for patients

What the risk profiles of their patient profiles look like compared to those of competitors and across payers

Quality, regulatory, operations, and financial stakeholders also need to understand the dynamics of the clinical, operational, and financial performance of the heart program –and where there are opportunities for improvement or celebration of achievement.

Stay tuned for Part 5 of Spotlight on Analytics, where we'll discuss Predictive Analytics. Parts 3, 2, and 1 are below.

Financial Impacts on Healthcare

Q: What are some of the key financial challenges facing healthcare providers today?

A: One of the big challenges is the rapid technology change from health tracking, diagnosis, and risk modelling. That, combined with growing care quality and population management solutions, will change the way we look at health.

Q: What are the financial benefits of using data analytics for healthcare providers?

A: The key financial benefits for providers are the ability to manage patient risk and tailor care plans more efficiently to improve patient health. Healthier patients will likely get better jobs and be able to afford more healthcare. (Who isn’t willing to spend on their family’s health?)

Remember, value equals cost / quality, so lower cost increases value and higher quality increases value. The U.S. healthcare industry is spending a lot of time looking at value in recent years. Patients, too, are slowly shifting to an awareness that they need to measure the cost of care against the quality of care.

Better targeting of care pathways and therapies will reduce variations in care and make the whole industry more efficient. By reducing costs and improving quality, providers and payers who embrace the new technologies will attract patients and payers looking for value.

Q: How does healthcare analytics tie into the trend toward evidence-based care?

A: Evidence from labs, meds, genomics and related biometrics will lead to more personalized medical care.

Q: How can hospital management use healthcare analytics to make financial improvements?

A: The keys to financial improvements in healthcare come from making efficient use of resources--from supplies to provider time, and from reducing variations in care due to identifiable variations in health status. The keys to success are understanding labor dynamics, making sure that the major care pathways are well defined and efficient, and managing outlier cases effectively.

Stay tuned for Part 4 of Spotlight on Analytics, where we'll discuss CV service line analytics.

The CVIS: What It Is Today and Where It’s Headed

It's no secret that healthcare in the United States is moving away from the fee-for-service model toward a value-based system that reimburses for positive health outcomes. The value of improved clinical outcomes is obvious—for patients, for providers, and for payers. As the healthcare industry shifts to value-based care, measuring and monitoring outcomes becomes increasingly important. Hospitals and payers must seek new and deeper ways to track performance.

In the cardiovascular specialties, the American College of Cardiology’s National Cardiovascular Data Registry (NCDR®) and the Society of Thoracic Surgeons’ (STS) national databases have set the standards for care for decades. The data sets required by the registries, and systems that have developed around managing that data, were the foundation of the original cardiovascular information management systems.

Over time, Cardiovascular Information Systems (CVIS) grew to capture significantly more data, resulting in more automated workflows and much more complete pictures of patient care. Today’s CVIS includes hemodynamic monitoring, ECG management, Echo management, structured reporting, and Picture Archiving and Communications (PACS) systems data. The CVIS of today can—and should—provide a 360°-view of the quality of a cardiovascular service line’s clinical care.

Chris Winquist, LUMEDX President and COO, discusses the CVIS.

Registry Data – Only the Basics

Through participation in the cardiovascular registries, CV service lines can understand their level of care compared with national counterparts. The national registries produce quarterly reports on comparative clinical outcomes, and offer insights for various stakeholders, from payers to individual physicians.

However, data insights only have value when they can affect change, and to do that, they must be timely. Because ACC and STS registry outcomes reports are made available only on a quarterly basis, change can be slow. Change in the kinds of processes and practices that affect outcomes can take up to a year or more after data is collected, submitted, and then reported. By the time a facility receives its outcomes report, the data originally submitted—and thus the registry report itself—is stale.

It's also important to note that registry data is only a basic set of the total data that could be analyzed and used to affect change. With today's ability to collect a much larger set of discrete data points in an efficient manner, deeper insights are possible, and decisions about clinical and operational strategy can be made at the local level.

Today's CVIS Leverages Data to Improve Your CV Business

Historically, the healthcare industry has generated large amounts of data, driven by compliance and regulatory requirements, and the need to deliver and demonstrate evidence-based patient care. But much of that data varies in format and location, and the ability to derive meaningful insights from it has been slow.

The opportunity for data to provide valuable insights in cardiovascular care is now available. We call it LUMEDX data intelligence, and leveraging this intelligence transforms the CVIS into something that goes beyond an information repository, data warehouse, or workflow efficiency tool.

The HealthView CVIS not only collects and warehouses data, but also provides drill-down ability to gain deep insights into every aspect of cardiac care and treatment: from risk factors to specific treatment success rates, discharge medications, readmission rates, and many more.

In fact, over the last 25 years, we've captured more than 30,000 discrete data points that are available to help you track metrics against objectives, identify outliers and trends, and work to improve patient care, population health, and business outcomes—all in one place.

The kind of deep insights that the CVIS of the (near) future will deliver will have a positive impact on the hospital as both a business and a patient-care facility. HealthView brings 21st century data intelligence to bear and eliminates the problems associated with minimal, and stale, data. Heart hospitals can now have a robust and active dataset, where new data enters the system every day. This makes the path to improved care faster, and better care means shared cost savings and dramatically improved patient outcomes.

The 27th Annual Scientific Sessions of the American Society of Echocardiography (ASE), coming up June 10-14 in Seattle, will bring together practitioners and top luminaries from across the country. The event will include the Inaugural Echovation Challenge competition, designed to foster and showcase novel approaches, technologies, and processes in echocardiography—and featuring a cash prize.

Other offerings at the event include:

n Chalk Talks, an opportunity to get answers from experts in the field of echo in an intimate setting.

n I♥Echo, a unique session allowing participants to practice all aspects of a focused cardiac ultrasound exam during the hands-on portion.

n Science and Technology Theater’s industry-supported symposia sessions during all four lunch breaks

n Posters featuring cutting-edge research on the latest advances in cardiovascular ultrasound or clinical cases illustrating evolutions in patient care

Are you going to ASE? Comment below and let us know which sessions you’re most looking forward to.

LUMEDX’s home base is in Seattle, and we’re excited about being part of ASE’s event. Visit our booth, #337, to learn about the latest in adult and pediatric echo workflow solutions, including innovative Integration and Analytics tools.

Industry Overview (continued)

Q&A With Gus Gilbertson, Product Manager for LUMEDX

Part 2 of our new series​. In this week’s installment, we continue our overview of the role of analytics in the healthcare industry.

Q: There’s been an increased focus on big data in other industries recently. How is the healthcare industry responding?

A: Data management is becoming an increasing focus in healthcare. Electronic Medical Records, HL-7 feeds, imaging systems, genomics, labs, and medications are all being gathered and increasingly mined for insight into health risks and outcomes. With the growing use of health, consumer, and business data--and shifts in regulatory guidelines, data governance and data resource management are growing in importance in healthcare.

Q: How is the healthcare industry different from other industries when it comes to data analytics?

A: In some ways, the EMR has been a black hole sucking in data for years, with limited options for analysis. Increasingly, a variety of tools are getting access to that data, and it is being supplemented with edge systems to create a fuller view of patient and population health.

In addition, different segments of the industry each use big data in different ways. Everyone uses big data to market to consumers. Payers and providers use it to identify care patterns. Pharmacies use it to better understand patient health and risks. Labs use big data to conduct more tests faster and cheaper, building a more complete picture of patient chemistry. Researchers use big data to help target therapies to specific sub-populations, or even to specific patients. Researchers and population-management teams are using big data to help target therapies to specific sub-populations, or even to specific patients.

Finally, regulatory bodies continue to grow their understanding of the Medicare population and how new therapies are affecting patient health and longevity. Service providers continue to use automation and natural language processing technologies to reduce service costs.

Q: Where do you see healthcare analytics going in five years?

A: Five years will come and go quickly, but I expect care quality measures will become increasingly public. Specific populations of chronic disease patients will find targeted communities that bring the fruits of big data to care patterns. Automation of diagnosis and risk profiling will make us all more keenly aware of our health.

Telehealth will become much more mainstream, supported by a variety of apps and home diagnostic solutions. In addition, healthcare risk profiles and the outcomes different risk factors influence will become a more prominent topic as individuals try to better understand how their health compares to that of relatives and the rest of the population, and look for opportunities to improve health, quality of life, and longevity.

Stay tuned for Part 3 of Spotlight on Analytics, where we’ll explore the financial challenges facing healthcare today. Part 1 of the series is below.

Industry Overview

Q: What are some of the challenges the healthcare industry is facing today?

A: Population management initiatives, service bundling programs, payor and provider consolidation, expanding regulatory oversite, an aging population, and expanding quality initiatives – all are increasing value in the U.S. healthcare industry, stretching resources, but also reducing competition.

At the same time, increased healthcare coverage has increased the number of paying customers in the industry. The growing focus on risk promises to change care planning for patients with diverse health profiles, but requires new ways of looking at patient care.

In addition, the increased availability of basic health monitoring data to individuals is helping people manage their health, but incentives for lifestyle change are still evolving. Telehealth is becoming an important healthcare/population health management tool that will likely to continue to disrupt existing on-site clinic and hospital models.

And finally (unfortunately): The growth in options for physically passive content consumption will continue to lead people down a sedentary path toward obesity and cardiovascular complications.

Q: Where do you see big data analytics fitting into the healthcare industry?

A: Increasingly, as more detailed consumer data becomes more accessible to healthcare organizations, they will be better positioned to identify health risks, manage chronic conditions, and tailor care offerings to match patient health profiles. They will also be able to better target marketing and healthcare service offerings to specific populations.

On the new treatments front, genetic factor analysis is becoming faster, easier, and cheaper. The next decade will see us looking at genetic data to better understand and predict health outcomes and guide diagnostic and treatment options.

Genomic analysis and cancer-risk profiling are a growing big-data topic, with genomic data for an individual patient taking big storage.

Natural language processing (NLP) is another big-data area that we can expect to start to impact the way we communicate and get things done. Most large vendors are using natural language processing technologies to respond to simple support and service requests. NLP is also being used to understand sentiment in a wide range of categories, often driven off of Twitter feeds. Expect NLP tools to come to your EMR or health records and analyze health risks.

This concludes Part 1 of Spotlight on Analytics, an ongoing series of blog posts. Stay tuned for Part 2!

C-suite leaders predict that their most important areas of focus in the next three years will be high-value post-acute care networks and innovative approaches to care delivery, according to Premier Inc.'s spring Economic Outlook. The impact that the Affordable Care Act and population health management will have on care delivery is the reason these areas of focus will be so important, executives say. "About 95 percent said expanding high-value post-acute care networks is crucial to population health efforts," FierceHealthcare reports. "In addition, 94 percent said such networks are one of their greatest challenges."

More than 1,000 institutions have been notified by the American College of Cardiology (ACC) that patient data from the National Cardiovascular Data Registry (NCDR) might have been breached. "After discovering the issue in December, the ACC found that four software development vendors who were testing software had access to NCDR patient data," reports Cardiovascular Business. "The data was copied between 2009 and 2010, and was included in one of more than 250 tables that software developers used in a test environment."

Warnings from the its Office of Inspector General have yet to prompt the Department of Health and Human Services to adequately address the issue of hospitals failing to employ safeguards and prevent electronic health record fraud and abuse via recommended tools already in place, according to the Inspector General. "The Inspector General's Office says that nearly all hospitals with EHRs had RTI-recommendedaudit functions in place, but that those functions were not being used to their full extent," FierceHealthcare reports.

The scores patients assign their hospitals appear to correspond with the quality of the hospitals' patient outcomes, according to a study published in JAMA Internal Medicine. Researchers analyzed the scores patients assigned to the Centers for Medicare & Medicaid Services' star-rating system for more than 3,000 hospitals. Hospitals' star ratings were inversely proportional to their rates of death within a month of discharge.

While the average primary care physician is generating less income for hospitals ($1.4 million in 2016 versus $1.56 million in 2013), that’s offset by specialist doctors, whose contribution to hospital revenues jumped 14% to $1.6 million, compared with $1.42 million three years ago. Among specialists, orthopedic physicians bring in the most business ($2.75 million each), followed by invasive cardiologists ($2.45 million) and neurosurgeons ($2.44 million.

Healthcare organizations named to Fortune's 20 Best Workplaces in Health Care share a sense of camaraderie and pride in their work, and offer lessons to other hospitals and systems that strive to create a positive work environment that can attract and retain the best talent. The winning organizations overcame the natural hierarchy of a healthcare organization to create a friendly, emotionally supportive workplace where coworkers feel as though everyone is equal and they can count on coworkers to support them.

Building on its rich history as the premier heart hospital in Wisconsin and a global destination for heart care, Aurora St. Luke’s Medical Center has received two prestigious accolades from the Accreditation for Cardiovascular Excellence (ACE). Both acknowledgments from ACE reinforce Aurora St. Luke’s positioning as a global leader in cardiovascular excellence.

As digitization of the healthcare system increases, issues around data exchange and medical records exchange make patient identification more challenging than ever. In the absence of a unique patient identifier system, doctors use a patient’s name and birth dates to identify them, and there can be hundreds or thousands of identical or similar names and dates in EMR systems. Get it wrong, and a diagnosis or treatment may be missed — sometimes with dire consequences.

Two decades have brought little change for women in cardiology, according to a new study. Women account for only 20 percent of cardiologists who see adult patients, and are more likely than their male counterparts to face professional discrimination.

Patients who take antidepressants are not increasing their risk of arrhythmia, MI, stroke or transient ischemic attack, according to new study. Prior research had suggested a link between depression and negative cardiovascular outcomes.

Eighteen people have been selected for a Distinguished Award from the American College of Cardiology (ACC). The recipients will receive their awards on April 4 during the ACC’s annual scientific session in Chicago.

One health system is using coordinated teams to cut emergency room visits and improve medication management for heart failure patients. A new blog post details how Geisinger Health System built on its record of care integration and coordination to address emergency and inpatient care for heart failure patients.

To reduce medical errors, providers should look to the skies, one physician writes. Following a 1977 airline disaster, the industry developed a "culture of safety" that could be worth emulating, writes David Nash, M.D., founding dean of Jefferson College of Population Health, Thomas Jefferson University.